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For this position we are seeking a RN or a Licensed Social Worker who must live and have a current active unrestricted license (LMSW, LBSW, LLMSW) in the state of MI.

This position will support our MMP (Medicaid Medicare Population). This position will have a case load and manage members enrolled in this program. We are looking for Registered Nurses who have experience working with manage care population and/or case management role. Excellent computer skills and diligence are especially important to multitask between systems, talk with members on the phone, and enter accurate contact notes. This is a fast-paced position and productivity is important. This position requires field work doing assessments with members face to face in homes.

Home office with internet connectivity of high speed required.

TRAVEL in the field to do member visits in the surrounding areas will be required: Macomb County (Detroit, Sterling Heights, Shelby Township, Macomb Township)

Travel will be up to 50% of the time (Mileage is reimbursed)

Schedule: Monday thru Friday 8:30AM to 5:00PM

JOB DESCRIPTION

Job Summary

Provides support for care management/care coordination activities and collaborates with multidisciplinary team coordinating integrated delivery of member care across the continuum. Strives to ensure member progress toward desired outcomes and contributes to overarching strategy to provide quality and cost-effective member care.

Essential Job Duties

• Completes assessments of members per regulated timelines and determines who may qualify for care coordination/care management based on triggers identified in assessments.

• Develops and implements care plan in collaboration with member, caregiver, physician and/or other appropriate health care professionals and member support network to address member needs and goals.

• Conducts telephonic, face-to-face or home visits as required.

• Performs ongoing monitoring of care plan to evaluate effectiveness, document interventions and goal achievement, and suggest changes accordingly.

• Maintains ongoing member caseload for regular outreach and management.

• Promotes integration of services for members including behavioral health, long-term services and supports (LTSS), and home and community resources to enhance continuity of care.

• Facilitates interdisciplinary care team (ICT) meetings and informal ICT collaboration.

• Uses motivational interviewing and Molina clinical guideposts to educate, support and motivate change during member contacts.

• Assesses for barriers to care, provides care coordination and assistance to member to address concerns.

• Collaborates with licensed care managers/leadership as needed or required.

• 25- 40% estimated local travel may be required (based upon state/contractual requirements).

Required Qualifications

• At least 2 years experience in health care, preferably in care management, or experience in a medical and/or behavioral health setting, or equivalent combination of relevant education and experience.

• Clinical licensure and/or certification required ONLY if required by state contract, regulation or state board licensing mandates.

• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance for job related travel requirements, unless otherwise required by law.

• Demonstrated knowledge of community resources.

• Ability to operate proactively and demonstrate detail-oriented work.

• Ability to work within a variety of settings and adjust style as needed - working with diverse populations, various personalities and personal situations.

• Ability to work independently, with minimal supervision and self-motivation.

• Ability to demonstrate responsiveness in all forms of communication, and remain calm in high-pressure situations.

• Ability to develop and maintain professional relationships.

• Excellent time-management and prioritization skills, and ability to focus on multiple projects simultaneously and adapt to change.

• Excellent problem-solving and critical-thinking skills.

• Strong verbal and written communication skills.

• Microsoft Office suite/applicable software program(s) proficiency.

• In some states, a bachelor's degree in a health care related field may be required (dependent upon state/contractual requirements).

Preferred Qualifications

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

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Pay Range: $24 - $46.81 / HOURLY

*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.